Remote Medical Director, Appeals at Centene

This leadership role is designed for a Board Certified Physician (MD or DO) with a strong background in clinical practice and an interest in the administrative side of healthcare. Ideally, you have experience in Utilization Management (UM) and are comfortable making high-level decisions regarding medical necessity, quality assurance, and complex appeals. The position offers a significant compensation package reaching up to $449k, alongside a fully remote work arrangement. As a Medical Director, you will bridge the gap between clinical care and business operations, influencing how care is delivered to millions of members while maintaining a focus on cost-effectiveness and regulatory compliance. **You might be a good fit if you:** * Hold an active, unrestricted MD/DO license and Board Certification (Internal or Family Medicine preferred). * Have a deep understanding of quality accreditation standards and utilization review processes. * Are comfortable reviewing controversial or experimental medical services to determine coverage. * Enjoy collaborating with care management teams to optimize outcomes for high-risk patient populations.